Microvascular changes and correlation with visual loss in pituitary adenoma

Abstract Purpose To determine microvascular changes and the correlation between microvascular interception and optic nerve damage in pituitary adenoma (PA) patients.Methods The vessel density of optic disc and macular retinal vessels was measured, using optical coherence tomography angiography (OCTA). It was performed that correlation between microvascular interception and optic nerve damage, including visual field and structural measurements. Results Seventy four eyes from 40 pituitary adenoma patients and 36 eyes from 24 healthy voluntary controls were recruited prospectively. Optic disc vessel density from PA patients with visual field defect (perimetric PA) was reduced and macular vessel density at superficial retinal capillary plexus (SCP) level from both perimetric and preperimetric PA patients was increased, compared to controls. Optic retinal vessel density was inversely correlated with visual field mean deviation and positively correlated with retinal structural measurements. Conclusions The retinal microvascular changes in pituitary adenoma patients presented as significantly decreased optic vessel density in perimetric stage and significantly increased SCP macular vessel density in preperimetric stage. Optic retinal vessel density in PA patients was associated with advanced visual field damage and optic nerve structural impairments. OCTA seems to be a reliable method to detect retinal microvascular changes and access the severity of visual loss in chiasmal compression caused by pituitary adenoma.